A multi-disciplinary study is proposed for emergency response management of disaster medical and mathematical discipline in the paper. The authors propose to evaluate the physical and chemical fragility and social fragility of Hainan province to search for methods to minimize local fragility; predict the level of disaster pre-warning using the time sequence model; calculate the medical personnel, equipments and drugs to be deployed at specific time and space by means of the probability method, and calculate on this basis the probability of the number of persons to be rescued against various emergencies. This aims at sending warning in advance and precisely mobilizing resources for medical emergency response.

Objective To investigate the relationship between levels of psychological resilience and coping styles of the patients with recurrence of nasopharyngeal neoplasms during hospitalization,in order to provide scientific data about the clinical psychological intervention.Methods A total of 240 cases of hospitalized patients with recurrence of nasopharyngeal neoplasms were selected and measured with general information questionnaire which was self-designed,resilience scale (CD-RISC) and coping scale.Results Resilience average score of patients with recurrent nasopharyngeal neoplasms was (53.22 ± 12.09) points,the level of resilience was positively correlated with positive coping and avoidance coping,P＜0.05,and negatively correlated with the yield coping,P＜0.05.Conclusions The resilience levels in patients with recurrence of nasopharyngeal neoplasms is below the medium level,resilience have a significant impact on patients' coping styles,and coping styles is affecting the level of resilience.In clinical work,health care workers should take effective measures to improve the resilience of patients so that patients take positive coping with disease.

AIM:To examine the latent membrane protein 1(LMP1)-DNA sequence in nasopharyngeal carcinoma(NPC) and detect mRNA expression of LMP1, EBNA1, EBNA2, and to explore the relationship between EBV infectious status, expression products and NPC carcinogenesis.METHODS: LMP1 DNA was detected in NPC by PCR. Direct sequence was applied to analyze the difference between NPC-LMP1-DNA and B95-8-LMP1-DNA. mRNA expressions of LMP1, EBNA1, EBNA2 in NPC were detected by nested RT-PCR.RESULTS: LMP1 DNA existed in all 47 NPC tissues. Several single nucleotide variations were found between NPC-LMP1-DNA and B95-8-LMP1-DNA. The notable variation was the lost of XhoⅠrestriction site in NPC. Direct sequence showed 30 bp deletion in NPC. The mRNA expressions of LMP1, EBNA1 and EBNA2 in NPC were 76.6%, 80.0% and 74.5% respectively by nested RT-PCR. The expression of EBNA1 in NPC was promoted by Q promoter while the expression of EBNA1 in B95-8 was promoted by C promoter.CONCLUSION: The way of EBV involved in NPC is complex. Latent genes such as LMP1, EBNA1 and EBNA2 as well as early lytic gene BARF1 may all play certain roles in NPC carcinogenesis.

Objective To build the access standard and role function of cancer case manager which is suitable for China.Methods The draft indicators of access standard and role function of cancer case manager were formulated based on literature review,group discussion and Delphi method.All the indicators were appraised by using two-round Delphi method.Results Round 1 consulting experts 43,and round 2 consulting experts 41.The experts showed high degree on the access standard and role function of cancer case manager during the two rounds of expert advice (two advisory Kendall coordination coefficients were 0.300,0.358 and 0.375,0.358,P ＜ 0.01).The access standard of cancer case manager included 4 first-level indicators and 34 secondary indicators,and the system of role functions included 7 first-level indicators,35 secondary indicators.Conclusions It indicates that the outcome is high reliability.The finding provide scientific basis for the selection of cancer case manager as well as clear identify of role functions which are significant for improving their work efficiency.

Objective To explore the CT dominant phase and optimal classification model in differenting clear cell renal cell carcinoma (ccRCC) from fat‐poor angiomyolipoma (fpAML) through quantitative multiple‐phase CT radiomic features analysis. Methods Clinical and imaging data of 195 cases pathologically confirmed ccRCC (n=131) and fpAML (n=64) were retrospectively studied. All the patients underwent non‐contrast enhanced CT scans and dynamic multi‐phase (corticomedullary phase, medullary phase and excretion phase) contrast‐enhanced CT scans. Regions of interest (ROIs) were manually delineated based on the selected image slices with the maximal diameter of the lesion using ITK‐SNAP software, followed by the acquisition of candidate CT radiomic feature sets from each phase with statistically significant differences by using Mann‐Whitney U test. Then, using the synthetic minority oversampling technique (SMOTE), 232 classification models which are composed of 29 different feature selection algorithms (top 10 features were chosen by the backward elimination method) and 8 different classifiers were constructed. Employing the 5‐fold cross‐validation method, the performance of each classification models for each phase was evaluated using accuracy (ACC), sensitivity (SEN), specificity (SPE) and area under receiver operating characteristic curve (AUC), to acquire dominant CT phases and the optimal classification models for distingushing ccRCC and fpAML, along with the key imaging radiomic features. Results In this study, the mean maximal diameter of ccRCC and fpAML lesions were (3.9±1.4) cm, and (3.5±1.7) cm, respectively, and there was no statistically significant difference in the size of the tumor between two groups (P>0.05). From 102 initial imaging feature sets, the total number of candidate imaging feature sets (P<0.05) were:non‐enhanced phase (n=26), corticomedullary phase (n=71), medullary phase (n=68), excretion phase (n=62). Among the 232 classification models through different combination of classifiers and feature selectors, the amount of classification models which achieved the maximum of AUC value (AUCmax) from different CT phases were: non‐enhanced phase (n=106, 45.7%), corticomedullary phase (n=94, 40.5%), medullary phase (n=23, 9.9%), excretion phase (n=9, 3.9%). Imaging features from non‐enhanced phase and corticomedullary phase yielded higher performance compared with medullary phase and excretion phase, with the corresponding optimal prediction models were SVM‐fisher_score (AUC: 0.897, ACC: 83%, SEN: 84%, SPE:80%) and Logistic Regression‐RFS (AUC: 0.891, ACC: 83%, SEN: 81%, SPE: 89%), respectively. Conclusions The quantitative imaging features from non‐enhanced and corticomedullary phase have better performance among proposed classification models than that from medullary phase and excretion phase. Furthermore, it is feasible to acquire proper combination of feature selection and classifiers to achieve high performance in identifying ccRCC and fpAML.

Objective: To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients. Methods: A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge). Results: The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01). Conclusion The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.

Objective: To obtain chimeric antigen receptor macrophages ( CAR-M) targeting HER2 stably transfected． Methods : CAR lentivirus vector targeting HER2 was constructed and infected with human monocytic leukemia cell line (THP-1) ．CAR THP-1 cells with green fluorescent labeling were selected by sorting flow cytometry and continued to be cultured in vitro．The CAR THP-1 cells targeting HER2 were co-cultured with the endometrial cancer cell line Ishikawa with negative and positive HER2 expression，and their targeted phagocytosis of CAR-M to HER2 positive tumor cells was detected by imaging flow cytometry ，and the targeted phagocytosis efficiency of CAR-M to HER2 positive tumor cells was detected by flow cytometry. Results : CAR lentivirus infection with THP- 1 cells was less efficient ; After co-culture with cancer cells，flow cytometry and imaging flow cytometry showed that CAR THP-1 cells had enhanced phagocytosis of HER2 positive Ishikawa cells compared with the empty body group (P＜0. 01) ． Conclusion In this experiment，CAR THP-1 cell line targeting HER2 was established by constructing CAR lentivirus vector and transfecting THP-1 cells ，and it was proved that CAR THP-1 could phagocytize HER2 positive Ishikawa cells through specific targeting.